A new report out from George Washington University’s Milken Institute School of Public Health shows that the vast majority of people who have private health insurance actually use the ACA’s free preventive care.
The law requires that most private insurance providers and group health plans have to pay for certain preventive services, with zero costs being passed on to the patient. The goal here is to drastically widen access to preventive care, covering key check-ups (like cholesterol and blood pressure), cancer screenings, immunizations, as well as many screenings and checks for pregnant individuals and children.
And it would seem to be succeeding, says the report. A review of private medical bills from FAIR Health reported that nearly two-thirds (62.2%) of those in qualified plans compliant with the ACA received one or more preventive services at absolutely no cost to them in 2024.
The researchers figure that about 100 million insured kids and adults got at least one of them.
Patients were not only able to access the care more easily but managed to save a significant amount of pocket change in the process, according to the report. It was discovered that typical couple’s family of four (two adults, two kids) receiving the full round of health screenings recommended under the rule could bank more than $4,000 a year in what they would have had to pay out of their own pockets without the protection of the ACA.
The intersection of clinical and financial health
The report adds to an established body of research showing that when you remove the price tag entirely, people are far more likely to get the preventive care they need, the university researchers pointed out.
Cost is still the number one obstacle for patients, and it’s more widespread than experts once thought. A late-year study in JAMA Internal Medicine found that nearly 1 in 4 patients struggles to pay for care or ends up dodging it entirely because of the cost.
If patients skip check-ups and tests, doctors more frequently miss underlying conditions, which typically means more pain, more sickness, and skyrocketing expenses down the line.
High-deductible health plans are popping up everywhere, forcing Americans to choose: do I get the check-up, or do I pay the rent? Employers also bumped up premiums and are shunting more expenses onto the backs of their staff.
The ACA’s mandate for full preventive benefit coverage seeks to ensure folks get the screenings that catch costly illnesses in their earliest, most manageable stages, especially for young children and the over-65 crowd.
The study found that kids up to age 9 are the most frequent flyers for preventive medical visits, specifically for immunization check-ups. In 2024, nearly 77% of this age group received a free ACA preventive service.
Roughly 66% of 50-64-year-olds and 63% of those 65 and up got in on the free screenings, too.
The ACA’s coverage rule skyrocketed patient access to services that received the coveted ‘A’ or ‘B’ rating from the U.S. Preventive Services Task Force, one of the top groups that decides which services make the cut.
Researchers say USPSTF’s work is of “special interest”
The USPSTF was first set up in the mid-1980s under President Reagan to push high-value preventive health care for everyone, at every age. It received its permanent legal footing in 1999, and later, the Obama administration tied its recommendations directly to ACA requirements.
The panel is made up of 16 volunteer members, top-tier national experts who specialize in primary care, prevention, and evidence-based medicine. They make clinical guidelines that determine which preventive services doctors should offer and what insurance must pay for.
The group is of “particular interest” to researchers because its recommendations cover every stage of a person’s life. All together, they have issued nearly 300 evidence-based guidelines spanning 90 different health topics.
However, a legal challenge was brought by some businesses and individuals who questioned whether the USPSTF’s authority was constitutional. The Supreme Court ultimately upheld it in 2025; however, the group hasn’t held a single meeting in over a year now, with HHS recently pushing off its third meeting in a row.
These repeated postponements have stirred up considerable anxiety and worry about the group’s future under the leadership of HHS Secretary Robert F. Kennedy Jr., even though HHS representatives state the meeting will happen again in the near future.
Just last June, Kennedy dismissed all 17 members of the CDC’s own Advisory Committee on Immunization Practices, putting seven of his own selections in place, a number of whom hold well-documented skepticism toward vaccines.
The USPSTF finds itself squarely in the middle of the ongoing political fight over the ACA, with many Republicans pushing to repeal or dramatically overhaul the law. Some conservative critics argue the group has a leftward slant, pointing specifically to its endorsement of preventive HIV medication.
Still, the researchers behind the report concluded that the findings “powerfully demonstrate how effective the USPSTF and other ACA-sanctioned panels are at pinpointing the most beneficial preventive care and making sure people can get it.”
HHS has not yet announced a confirmed date for the next USPSTF meeting.
Jacqueline LaPointe is a graduate of Brandeis University and King’s College London. She has been covering healthcare finance and revenue cycle management since 2016.
